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CoxarthrosisESPB_HIPNCT06282666

Lumbar ESPB in Hip Replacement Surgery

A study testing Spinal anesthesia, lumbar erector spinae plane block and Epidural analgesia in people with Coxarthrosis and Pain, Postoperative, run by Medical University of Lublin at 1 site in Poland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

In this study, continuous erector spinae plane block (ESPB) will be compared to continuous epidural analgesia in patients undergoing elective hip replacement surgery. Opioid consumption, pain severity, quadriceps femoris muscle strength, ability to walk, and quality of recovery will be evaluated. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Coxarthrosis, Pain, Postoperative, Pain, Acute
What is being tested?
Spinal anesthesia, lumbar erector spinae plane block and Epidural analgesia
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 sitePoland
Study dates
19 Feb 2024to 1 Aug 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • primary hip replacement surgery due to coxarthrosis
  • anesthetized with spinal technique
  • able to use PCA pump
  • having access to phone

Who cannot join

  • patients taking painkillers not related to coxarthrosis;
  • having active cancer,
  • dementia or challenging contact with the patient;
  • suffering from depression or other psychiatric disorders that required antidepressant treatment;
  • consuming alcohol or recreational drug addiction;
  • contraindications to the regional block.

Trial locations and contacts

1 site in 1 country.

Poland1 site
  • II Department of Anesthesia and Intensive Care

    Lublin, 20-081

Other trials in Poland

About this study

Official title: Comparison of Continuous Lumbar Erector Spinae Plane Block to Continuous Epidural Analgesia in Patients Undergoing Hip Replacement Surgery

In this study, continuous erector spinae plane block (ESPB) will be compared to continuous epidural analgesia in patients undergoing elective hip replacement surgery. Opioid consumption, pain severity, quadriceps femoris muscle strength, ability to walk, and quality of recovery will be evaluated. Moreover, chronic pain severity in months after the hospital discharge will be assessed.

Read the detailed description

This is a prospective trial in patients undergoing elective hip replacement surgery.

Written informed consent will be obtained from each patient, and our study will be conducted following the tenets of the Declaration of Helsinki for medical research involving human subjects.

Before the surgery, preoperative pain severity, chronic pain severity, and ability to sit, stand, and walk will be assessed.

Each participant will be anesthetized with spinal technique and randomly allocated patients according to postoperative analgesia to the continuous epidural (Epidural) group and the continuous lumbar erector spinae plane block (ESPB) group. Both regional techniques will be continued during the first day. Investigators will measure postoperative oxycodone consumption with a patient-controlled analgesia (PCA) pump. At several points, the patients' pain at rest and during activity will be evaluated on the visual analog scale (VAS, 0-10), their quadriceps femoris muscle strength on the Lovett scale (0-5), and their ability to sit, stand upright, and walk on the Timed Up and Go test. Moreover, the patient's recovery will be assessed through the Quality of Recovery 40 (QoR-40) questionnaire on the first postoperative day.

After the patient's discharge, information regarding acute and chronic pain severity and quality of recovery will be collected during the phone interview.

Being tested
Spinal anesthesia, lumbar erector spinae plane block, Epidural analgesia, patient-controlled analgesia, Timed Up and Go test
Keywords
erector spinae plane block, epidural analgesia, quality of recovery, patient-controlled analgesia, Timed Up and Go test, visual analog scale, neuropathic pain symptom inventory, Lovett scale, spinal anesthesia
Medical subject headings
Osteoarthritis, Hip, Pain, Postoperative, Acute Pain, Chronic Pain, Agnosia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Spinal anesthesiaProcedure or surgery

    Also called Subarachnoid anesthesia

    Before the beginning of surgery, all patients will be anesthetized with 0.5 % hyperbaric bupivacaine (Marcaine Heavy), 1.5 - 2.5 mL solution. A pencil point spinal needle will be used.

  • lumbar erector spinae plane blockProcedure or surgery

    Also called ESPB

    Investigators will perform the lumbar ESPB under ultrasound control at the L3 level on the ipsilateral site of the surgery. After dissection with 0.9 NaCl, we will leave a catheter in the ESP. Then, we used 0.25% bupivacaine with epinephrine (5mcg/mL), 0.4 mL per kg, up to 40 mL.

  • Epidural analgesiaProcedure or surgery

    After identifying the epidural space and spinal anesthesia (combined technique), a catheter will be placed in the epidural space. Investigators will give an epidural catheter a test dose of 2% lidocaine (2 mL). At the end of the surgery, the patient will receive 5 mL of a mixture containing 0.1% bupivacaine with fentanyl (2 mcg/mL).

  • patient-controlled analgesiaProcedure or surgery

    Also called PCA

    Each participant will receive a pump with oxycodone (1mg/ml) using a patient-controlled analgesia (PCA) technique, a bolus of 1 mL, and a lockout of 5 minutes for the first postoperative day.

  • Timed Up and Go testDiagnostic test

    Also called TUG

    Investigators will measure the time the patient took to rise from a chair, walk three meters, turn around 180 degrees, walk back to the chair, and sit down while rotating 180 degrees. We will assess the patient before the surgery and 24 and 48 hours after hip replacement.

  • neuropathic pain symptom inventoryDiagnostic test

    Also called NPSI

    The Neuropathic Pain Symptom Inventory (0-100; 0 denotes no pain, 100 the most severe pain) will be evaluated before the surgery and three and six months following the procedure.

  • Lovett testDiagnostic test

    A physiotherapist will use the six-grade Lovett scale to measure muscle strength, in which 0 denotes no muscle contractility, and 5 denotes the complete range of motion against gravity, with full resistance. We will test this before the surgery, 24 and 48 hours after the operation.

  • Visual analog scaleDiagnostic test

    Also called VAS

    Investigators will measure pain intensity with VAS (0-10; 0 denotes no pain, 10 maximal pain) before and after the surgery. Pain will be evaluated at rest and upon the activity.

  • Quality of Recovery 40Diagnostic test

    Also called QoR-40

    Investigators will assess the quality of recovery with QoR-40 a day after the surgery, a month, and three months following the procedure. The minimal score is 40, and the maximal is 200. The higher the result, the better the quality of recovery is.

  • Ability to sit, stand upright, and walkDiagnostic test

    A physiotherapist will evaluate the patient's ability to sit, stand upright, and walk at planned times.

Study groups in NCT06282666
Study groupRoleWhat they receive
EpiduralExperimentalCombined spinal and epidural anesthesia will be performed before the surgery in the patient's lateral position with the operated hip down. The Espocan set will be used (B.Braun). After identification of the epidural space on the level of L3/L4, 0.5% bupivacaine (Marcaine Heavy Spinal) with fentanyl (5 mcg/mL) will be injected through the 27 G pencil point spinal needle. Then, the epidural catheter will be placed and a test dose of 2% lidocaine (2 mL) will be administered. At the end of the surgery, the patient will receive 5 mL of a mixture containing 0.1% bupivacaine with fentanyl (2 mcg/mL). Moreover, we will administer 5 mg of oxycodone i.v. the mixture of bupivacaine and fentanyl will be administered in a constant flow of 5 mL/h for a day.
Receives: Procedure: Spinal anesthesia; Procedure: Epidural analgesia; Procedure: patient-controlled analgesia; Diagnostic Test: Timed Up and Go test; Diagnostic Test: neuropathic pain symptom inventory; Diagnostic Test: Lovett test; Diagnostic Test: Visual analog scale; Diagnostic Test: Quality of Recovery 40; Diagnostic Test: Ability to sit, stand upright, and walk
ESPBExperimentalSpinal anesthesia will be performed in the patient's lateral position with the operated hip down. 0.5% bupivacaine (Marcaine Heavy Spinal) with fentanyl (5 mcg/mL) will be used and a 25-27 G pencil point spinal needle. The lumbar ESPB will be performed under ultrasound control at the L3 level on the ipsilateral site of the surgery. After dissection with 0.9 NaCl, a catheter will be left in the ESP. Then, we will administer 0.25% bupivacaine with epinephrine (5mcg/mL), 0.4 mL per kg, up to 40 mL. Moreover, 5 mg of oxycodone i.v. will be administered A mixture of 0.1% bupivacaine with fentanyl (2 mcg/mL) will be given in a constant flow of 5 mL/h for a day.
Receives: Procedure: Spinal anesthesia; Procedure: lumbar erector spinae plane block; Procedure: patient-controlled analgesia; Diagnostic Test: Timed Up and Go test; Diagnostic Test: neuropathic pain symptom inventory; Diagnostic Test: Lovett test; Diagnostic Test: Visual analog scale; Diagnostic Test: Quality of Recovery 40; Diagnostic Test: Ability to sit, stand upright, and walk

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Opiod consumtion with PCA

    Oxycodone consumtion used with a patient-controlled analgesia pump

    Measured: From the admission to the postoperative care unit to the next postoperative day for 24 hours.

Secondary outcomes (6)
  1. Pain at rest

    Pain measured at rest on the VAS (0-10)

    Measured: 24 hours before the surgery, after the surgery immediately in the postoperative care unit, 4, 8, 24, and 48 hours following the operation

  2. Pain upon activity

    Pain measured upon activity on the VAS (0-10)

    Measured: 24 hours before the surgery, after the surgery immediately in the postoperative care unit, 4, 8, 24, and 48 hours following the operation

  3. Lovett test

    The quadriceps femori's muscle strength on the Lovett scale (0-5)

    Measured: 24 hours before the surgery, 24 and 48 hours after the operation

  4. TUG

    Timed Up and Go test in seconds

    Measured: 24 hours before the surgery, 24 and 48 hours after the operation

  5. QoR-40

    quality of recovery 40

    Measured: It will be measured 24 hours, 30 days, and three months following the surgery.

  6. NPSI

    The Neuropathic Pain Symptom Inventory will be measured personally and after the discharge with a phone interview.

    Measured: 24 hours before the surgery and 3 and 6 months following the operation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Feb 2024
  2. Study start19 Feb 2024
  3. Primary completion1 Feb 2025
  4. Study completion1 Aug 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two groups will be randomly allocated to Epidural and ESPB (1:1)
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06282666
Sponsor's protocol ID
KE-0254/150/2019
Acronym
ESPB_HIP
Status last verified
Jul 2024
First submitted
12 Feb 2024
Last updated
8 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Hanych A, Kutnik P, Pasiak P, Zakrzewska-Szalak A, Wichowska O, Jednakiewicz M, Nogalski A, Piwowarczyk P, Borys M. Continuous lumbar erector spinae plane block as an alternative to epidural analgesia in pain treatment in patients undergoing hip replacement surgery - a prospective pilot study. Anaesthesiol Intensive Ther. 2023;55(4):272-276. doi: 10.5114/ait.2023.132517.

    PubMed 38084571

Questions about this trial

What is this clinical trial studying?

A study testing Spinal anesthesia, lumbar erector spinae plane block and Epidural analgesia in people with Coxarthrosis and Pain, Postoperative, run by Medical University of Lublin at 1 site in Poland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Poland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Opiod consumtion with PCA (time frame: From the admission to the postoperative care unit to the next postoperative day for 24 hours.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06282666, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2026.

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